Modified Mohs surgery is a procedure which eliminated chemical fixation step from Mohs chemosurgery. This technique is faster, less painful and more tissue conserving, allows for immediste repairs, yields higher quality histologic preparations and facilitates an interdisciplinary apporoach; it is the treatment of choice for recurrent or difficult skin cancers. A 58-year-old femele patient presented with a 2x 3cm sized dark brownish, ulcerated nodule on the left upper eyelid. Histopathologic findings revealed several small solid nest composed of basalioma cells in the dermis. We treated with modified Mohs surgery and obtained good result.
Carcinoma, Basal Cell* ; Dermis ; Eyelids ; Humans ; Middle Aged ; Mohs Surgery* ; Skin Neoplasms ; Ulcer

No abstract available.

BACKGROUND: The purpose of this article was to identify the risk factors related to development of hemodynamically significant cardiac arrythmias in patients with mechanical ventilation. METHODS AND RESULTS: Holter recording and echocardiogram were performed after 30 minutes of ventilator initiation in patients on mechanical ventilation(MV) owing to respiratory failure(RF) from various reasons. From 68 patients, hemodynamically significant cardiac arrythmias were detected in 18 patients(26.5%). Initial mean arterial pressure, maximal heart rate, and initial pH were identified as risk factors for hemodynamically significant cardiac arrythmias. Additionally, the patients with pressure-controlled ventilation as an initial ventilatory mode developed hemodynamically significant cardiac arrythmias less frequently than the patients with other modes(15.8% vs. 40%, p=0.03). In multivariate analysis, initial mean arterial pressure(<70mmHg, odds ratio[OR]:5.5;95% confidence interval[CI]:1.2 to 24.2, p=0.026), maximal heart rate(>120/min, OR:19.7;95% CI:2.0 to 190.0, p=0.01), and pressure-controlled ventilation(OR:0.13,95% CI:0.03 to 0.55, p=0.006) were associated with the development of hemodynamically significant cardiac arrhythmias. CONCLUSION: Theses findings suggest that during the early stages of mechanical ventilation with acute respiratory failure, hemodynamically significant cardiac arrhythmias are directly associated with tachycardia(>120/min), initial MAP(<70mmHg), and, inversely, the initial use of pressure-controlled ventilation.
Arrhythmias, Cardiac* ; Arterial Pressure ; Heart ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Multivariate Analysis ; Respiration, Artificial* ; Respiratory Insufficiency* ; Risk Factors* ; Ventilation ; Ventilators, Mechanical

Lymphomatoid papulosis (LyP), first described by Macaulay in 1968, is a paradoxical skin disease characterized by a generally clinical benign course, in contrast to malignant histological features. LyP is rarely seen in children. We herein report a case of LyP in a 10-year-old boy who had a 4-week history of multiple, scattered erythematous papules, crusted papules or ulcerated papules on the trunk, arms and thighs. Histopathologically, there was a superficial and midderma1 perivascular and interstitia1 infiltrate composed primarily of lymphocytes, which were admixed with large, atypical, mononuclear cells with pleomorphic nucleus. These atypical cells expressed CD30 (Ki-1) antigen. This is the first reported case in Korea of LyP present in a child.
Arm ; Child* ; Humans ; Korea ; Lymphocytes ; Lymphomatoid Papulosis* ; Male* ; Skin Diseases ; Thigh ; Ulcer

PURPOSE: Our purpose in this study is to evaluate the effectiveness of bronchial and nonbronchial systemic arteries for the control of hemoptysis. MATERIALS AND METHODS: Seventy patients with massive or recurrent hemoptysis underwent percutaneous transcatheter embolotherapy between 1991 and 1993. Retrospectively we reviewed 77 cases of bronchial artery embotization and 32 cases of nonbronchial systemic artery embolization in the 70 patients. RESULTS: Immdiate control of hemoptysis was achieved in 33 of 39 patients with massive hemoptysis(84.6%) and 20 of 24 patients with recurrent hemopt ysis(83.3%). In 32 cases, nonbronchial systemic arteries contributed significantly to areas of pathologic pulmonary tissue and frequently were the major arterial supply. CONCLUSION: Bronchial artery embolization is an effective and life saving procedure in non-surgical candidates. Recognition and occlusion of nonbronchial systemic arteries that feed to hypervascular pulmonary lesions is essential for successful percutaneous embolotherapy of hemoptysis.
Arteries ; Bronchial Arteries ; Embolization, Therapeutic ; Hemoptysis* ; Humans ; Retrospective Studies

The antepartum death of one fetus in twin pregnancy is a rare obstetric complcation. If one fetus in twin pregnancy died in uterus remote from term and another fetus did not, the dead fetus will be compressed between the uterine wall and the membrane of living fetus, becomes a fetus compressus or fetus papyraceous. The primary maternal threat when the fetuses undelivered is disseminated intravascular coagulation. Concern for the surviving fetus after death of its co-twin is balanced between the risks of preterm birth and those involving exposure to events in utero that may threaten its well-being. Recently we experienced a case of twin pregnancy complicated by the death of one fe- tus, we report this case with concerned literatures.
Disseminated Intravascular Coagulation ; Fetal Death* ; Fetus ; Humans ; Membranes ; Pregnancy, Twin* ; Premature Birth ; Twins* ; Uterus

The subjects, under 18 old, 2,694 children who visited ER during 199H, were surveyed by the Triage and other statical data. The results were as follows : 1. The male to female ratio was 1.7 : 1, and the toddler(1-4 old) was the majority. 2. Triage : critical 1.3%, acute 14.6%, urgent 29.5%, nonemergent 54.6%. 3. The reasons of visiting ER : 1) The children had diseases(46.5%), injury (36.9%), TA(5.6%) and toxication(1.0%). 2) In diseases, male to female ratio was 1.5 : 1 and in injury, male to female was 2 : 1. 3) Among the children having in TA, 12-18 old groups was the majority(34.9%). 4. The time of visiting ; the 20 : 00-22 : 00 was the majority(16.9%). 5. By monthly and seasonal distribution ; Jan. (9.7%?), Mar. and May(9%) respectively, Dec. and July(6.7%) respectively. The children who visited ER in spring and autumn showed higher portion than those of summer and winter. 6. Results : admission(27.4%), discharge(68.4%), operations(2.8%), and DOA and DAA(0.4%). The mortality of the infancy and toddler groups was 83.3%. The infancy group showed the highest rate of admission. 7. The time of staying in ER : 1-2 hrs was the major group(23.3%) and the average was 4.6 hours. 8. By clinical departments ; Ped, was 34.4%, PS was 20.8.%, Dental Surgery was 10.3% and Dermatology was 0.9%. 9. The types of visiting : the group who visited by themselves was 80%, transfer from the primary and secondary clinic was 17% and OPD was 3.0%. 10. The traffic means ; by the own cars and taxi were 87.6%, by hospital ambulance was 6.1% and by 119 ambulance was 4.3%.
Ambulances ; Child* ; Dermatology ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Mortality ; Seasons ; Triage* ; Child Health

The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2. The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).
Ambulances ; Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Mortality ; Seasons ; Surgery, Oral ; Triage*

BACKGROUND: Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. METHODS: The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. RESULTS: The PEFR measured with MPFM was significantly related to the PEFR and FEV1 measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r=0.92 p<0.001; for FEV1, r=0.78 ; p<0.001). The accuracy of MPFM was within 10%(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being I 6.5L/min(percentage of difference being 2.90%) or 1 0.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or -20.49~ + 9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p>0.05) and the coefficient of variation(2.4 1.2%) of PEFR measured with MPFM was significantly lower than that( 5.2 3.5%) with standard pneurnotachygraph in normal (p<0.05). CONCLUSION: This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.
Asthma ; Diagnosis ; Flowmeters ; Peak Expiratory Flow Rate ; Respiratory Function Tests

BACKGROUND/OBJECTIVES: Eating-out among Korean people has become an important part of modern lifestyle due to tremendous growth of the food service industry and various social and economic changes. This study examined trends in meal patterns and meal sources while eating-out among Korean adults aged 19 years and older. SUBJECTS/METHODS: Data were from the 1998-2012 KNHNES (Korea National Health and Nutrition Examination Survey) by the 24-hour dietary recall method. This study included 55,718 adults aged 19 years and older. For analysis of eating-out frequency, data were categorized by source of meals and serving place. RESULTS: Average frequency of meals consumed away from home increased from 1998 to 2012, although it remained lower than that of meals at home. In addition, male, unmarried, employed, higher educated, and high income individuals more frequently consumed meals away from home. Moreover, sodium intake while eating-out significantly increased from 2,370 mg in 1998 to 2,935 mg in 2012. Lastly, percentage contributions of daily total protein intake, fat intake, and sodium intake from eating-out increased to more than half (53-55%) in 2012 compared with 47-48% in 1998. CONCLUSIONS: As eating-out has grown in popularity, greater recognition of public health and nutritional education aimed at promoting healthy food choices is needed. In addition to developing consumer education for overall healthier eating patterns, individuals who are younger, unmarried, higher educated, and males are especially at risk and require attention.
Adult* ; Eating ; Education ; Food Services ; Humans ; Korea ; Life Style ; Male ; Meals ; Nutrition Surveys* ; Public Health ; Single Person ; Sodium